ACOs Needed 'Now,' Former CMS Admin Says

Spiraling healthcare costs make the immediate implementation of accountable care organizations (ACOs) a must, according to Mark McClellan, MD, former Administrator for the Centers for Medicare and Medicaid Services (CMS).
In a plenary speech yesterday at the National Health IT and Delivery System Transformation Summit, held in conjunction with Second Annual National Accountable Care Organization Summit in Washington, D.C., McClellan deemed the challenge of achieving better care at lower costs never more important or more urgent than it is now. But at the same time, he notes, the significant challenges of “getting from here to there” in terms of ACO establishment have never been more daunting.
McClellan, who now serves as director of the Engelberg Center for Health Care Reform at the Brookings Institution, says CMS during the past year has identified many challenges faced by providers when starting an ACO – and there are now some successful ACOs from which to draw experience.
"ACOs are about fundamental changes," he asserts. "The main emphasis is to get away from fee-for-service payment structure.”
McClellan added that "ACOs are not going to be an immediate solution to all (U.S. healthcare) problems, but neither is anything else."
Moreover, he notes, ACOs “aren’t going away” despite the difficulties faced in launching them, and, as part of the Affordable Care Act, they comprise a comprehensive strategy to get better care at a lower cost. "They are not a bunch of reforms we're throwing up against the wall to see what sticks," he says.
McClellan predicts the final ACO rule, expected out this summer, should have "a lot of changes" compared to the March proposal. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius, who also spoke at the conference's opening session, says HHS has "listened" and weighed the interest of stakeholders after proposing the ACO rule in March. Since then, HHS has received 1,200 comments, she reports.
HHS is looking for ways "to find the best balance" between stabilizing costs and protecting patients. The ACO model will reward physicians for keeping their patients healthy in the first place, Sebelius emphasizes.